Understanding What is Dual-Diagnosis
What is Dual-Diagnosis?
(Mentally Ill and Chemically Abusing)
Dual-diagnosis is the name given to client's dealing with both chemical addiction symptoms and mental health issues at the same time. Dual-diagnosis is also referred to as mentally ill and chemical abusing. One of the biggest difference in the addiction recovery treatment process is that chemical dependent people are expected to stay abstinent, while mentally ill client's, who may also need help for addiction recovery, are supposed to use alternative styles including harm reduction.
Dual-diagnosis presents a problem for many treatment centers, especially when a court is involved, because of the different needs presented by MICA clients.
Some agencies have programs for both for Dual-diagnosis or, mentally ill and chemically abusing (MICA) clients. The difference is Dual-diagnosis treatment treats both issues equally, while MICA treatment focuses more on the mental health treatment. In either case, client's are allowed to stay on mental health medications, which are not of the addictive nature.
Similarities Between Dual-diagnosis and Chemical Dependency
Both are life time issues.
Both may be progressive if not treated.
Recovery is gradual.
Both involve denial and resistance to abstinence or life changes.
The more support available, the better the chance of recovery.
Both are still viewed by society with a stigma or prejudice.
Differences in Dual-diagnosis and Chemical Dependency
The treatment of mental heath symptoms is more flexible than chemical dependency.
Abstinence is not the goal as much as management of the person as a whole.
Medication is to be taken daily to keep the client's symptoms under control.
It is as easy to miss mental health symptoms in chemical dependency client, as it is also easy to miss addictions in mentally ill and chemically abusing (MICA) patients.
The medical field is more involved in mentally ill and chemically abusing (MICA) treatment with the aid of psychiatrists and psychologists.
Mentally ill and chemically abusing (MICA) client's have more trouble in addiction recovery group settings.
Sometimes mentally ill and chemically abusing (MICA) client's will use the disease as an excuse for not functioning.
At other times the depth of the disease does in fact limit functioning.
More concrete and direct guidance is needed with mentally ill and chemically abusing (MICA) client's.
The stress level of dealing with two diseases is higher than just one.
Addiction recovery in mentally ill and chemically abusing (MICA) patients is usually less confrontive with the issues.
Many believe if the mental health issues are controlled, the addictions will subside.
Medication is used in most mentally ill and chemically abusing (MICA) patients and as vital to recovery as counseling
The crisis level present in mentally ill and chemically abusing (MICA) client's appears greater, due to their inability to control their impulsive behavior, especially apparent when attempting addiction recovery.
There are now Dual-diagnosis sober support groups, since many addiction recovery groups believe the problem to be all dependency.
Dual-diagnosis and Addiction Treatment
Mental Health Evaluation and Symptoms of Dual-diagnosis.
Schizophrenia which is characterized by hallucinations, delusions, apathy and withdrawal from life.
Affective disorders are characterized by mania, depression and delusions.
Personality ambivalence, lack of concern towards social adaptation and skills and resistance.
There are factors that lead up to mental health and chemical dependency issues both.
Family stress, society, low self image, drugs or alcohol, are just a few.
Psychological issues include poor self image and unsuccessful defense system.
Behavior symptoms are unpredictable, anger, fear, withdrawal and suicidal ideations.
Social symptoms are family failure, also failures in school, work and recreational areas.
Problems in diagnosing are denial and lack of information.
Common Definitions in Dual-diagnosis Addiction Rehabilitation
From theDiagnostic Statistical Manual (DSM), which is used to make a diagnosis of mental illness.
Mood: Sustained emotion. (depression, elation, anger or anxiety)
Affect: Pattern of observable behaviors that is the expression of the feelings.
Psychosis: Usually refers to hallucinations, delusions also disorganized speech or behavior.
Hallucinations: Sensory perception in the absence of a real stimuli.
Delusions: Fixed false belief that cannot be shaken despite evidence.
Panic Attacks: Periods of intense apprehension, fearfulness or terror.
Intoxication: Behavior symptoms directly related to use of a substance.
Abuse: Problematic behaviors associated with use.
Dependence: Pattern of recurrent use, misuse and dysfunctional consequence of use.
Five Axis Used for Diagnosis in Addiction Rehabilitation
Axis I Major Psychiatric Syndromes.
Axis II Developmental and Personality Disorders.
Axis III Non-Psychiatric Medical Conditions.
Axis IV Stressors. (immediate problems)
Axis V Global Functioning. (overall ability to function in life)
Standard Assessment of Dual-diagnosis for Addiction Treatment
Presenting a situation that brings clients in with a history of present illness.
Past Psychiatric Care.
Drug and Alcohol History.
Past Medical History.
Medications and Allergies.
Legal History.
Family History.
Social History.
Mental Status Exam.
Impression of Clinician after reviewing information.
